Predictors and outcomes of healthcare-associated infections in COVID-19 patients

Gagan Kumar, Alex Adams, Martin Hererra, Erine Raybon Rojas, Vartika Singh, Ankit Sakhuja, Mark Meersman, Drew Dalton, Shravan Kethireddy, Rahul Nanchal, Achuta Kumar Guddati

Research output: Contribution to journalArticlepeer-review

51 Scopus citations


Introduction: Healthcare-associated infections (HAI) after viral illnesses are important sources of morbidity and mortality. This has not been extensively studied in hospitalized COVID-19 patients. Methods: This study included all COVID-19-positive adult patients (≥18 years) hospitalized between 01 March and 05 August 2020 at the current institution. The Centers for Disease Control and Prevention definition of HAI in the acute care setting was used. The outcomes that were studied were rates and types of infections and in-hospital mortality. Several multivariable logistic regression models were constructed to examine characteristics associated with development of HAI. Results: Fifty-nine (3.7%) of 1565 patients developed 140 separate HAIs from 73 different organisms: 23 were Gram-positive, 39 were Gram-negative and 11 were fungal. Patients who developed HAI did not have higher odds of death (OR 0.85, 95% CI 0.40–1.81, p = 0.69). HAIs were associated with the use of tocilizumab (OR 5.04, 95% CI 2.4–10.6, p < 0.001), steroids (OR 3.8, 95% CI 1.4–10, p = 0.007), hydroxychloroquine (OR 3.0, 95% CI 1.0–8.8, p = 0.05), and acute kidney injury requiring hemodialysis (OR 3.7, 95% CI 1.1–12.8, p = 0.04). Conclusions: HAI were common in hospitalized Covid-19 patients. Tocilizumab and steroids were associated with increased risk of HAIs.

Original languageEnglish (US)
Pages (from-to)287-292
Number of pages6
JournalInternational Journal of Infectious Diseases
StatePublished - Mar 2021


  • COVID-19
  • Hydroxychloroquine
  • Secondary infections
  • Tocilizumab

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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